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What is a Lifetime Benefit Maximum?

A lifetime benefit maximum is a cap on the total amount of benefits available to a member. The cap is designed to keep the cost of benefits affordable, to better manage the health care received and to stabilize potential future costs. Most lifetime benefits maximums are capped at either $1,000,000 or $2,000,000.

  • Lifetime benefit maximums are most often applied to:
  • Mental, nervous, drug and/or alcohol treatment expenses
  • Organ transplant benefits

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